其证卒然仆倒,身体强直,口噤不语,或四肢战掉,厥逆身冷,无汗,醒后恶
寒,或发热,或不发热,脉沉细弦紧,腹痛。此与《伤寒论》寒邪直中三阴经同理,
但彼不至卒倒之甚耳。治之先用酒调苏合香丸,次用五积散,加香附一钱,麝香少
许。重则用姜附汤。若人渐苏,身体回暖,稍能言语,问其别有何证。寒,脉迟紧。
挟气带洪,攻刺作痛,附子理中汤加木香五分;挟风带浮,眩晕,加防风一钱;挟
湿带濡,肿满疼痛,加白术一钱。筋脉牵急,加木瓜一钱。肢节疼痛,加桂一
钱。亦可灸丹田穴,以多为妙。大抵中在皮肤则为浮,(浮肿也,观冻疮之肿可见。)中在肉
则为苛、为肿、为聚液,(血液不行。)分裂而痛,或痛在四肢,或痛在胸胁,或痛在胫
背,或痛在小腹引睾,(大抵初时周身受寒,后则并走一处,盖视其虚而入之也。)或经络引注脏腑之
膜原,为心腹痛,或注连于脏腑,则痛死不知人。中于筋骨,为筋挛骨痛,屈伸不
利。中入腑脏则死矣。治当察微甚。甚则附子理中汤,无汗加麻黄、细辛,呕吐加
丁香、吴茱萸,阴毒加生川乌,脉微欲绝加人参。微则不换金正气散加附子,五积
散。脐腹痛,唇白甲青,四肢厥,附子理中汤、姜附汤。入肝加木瓜,入肺加
桑白皮,入脾加白术,入心加茯苓。麝香、半夏、皂角各二钱半为末,填脐中,生
姜切片盖之,艾灸至手足温为度,或灸丹田穴。因房事致手足冷,腹绞痛者,亦然。
冻倒人不得近火,近火即逼寒气入心而死矣。北方之人手足冻僵,若汤浴火炙,则
肢节脱落。须缓缓搓之,俟其回暖,或反以雪搓之,引出寒气,气舒暖回乃愈,即
其理也。(僵冻成冰,坚凝不解,以火遽逼,则先融者与未融者解离不接,故脱落也。又水流湿,火就燥,皮肤之
寒为内阳所拒,原欲外出,而苦于无所引,以雪搓之,则以寒就寒而外附,于是内阳得伸,而暖回也。)
The symptoms manifest as sudden collapse, rigidity of the body, locked jaw with inability to speak, or trembling of the four limbs, cold extremities and body, absence of sweat, aversion to cold after regaining consciousness, or fever, or no fever, with a deep, fine, wiry, and tight pulse, accompanied by abdominal pain. This shares the same principle as the direct invasion of the Three Yin Meridians (Three Yin Channels) by cold pathogenic factors in *Shanghan Lun* (Treatise on Cold Damage), though it does not reach the severity of sudden collapse. Treatment should first employ Suhe Xiang Wan (Styrax Pills) mixed with wine, followed by Wuji San (Five Accumulations Powder) with one qian of Xiangfu (Cyperus Rhizome) and a small amount of Shexiang (Musk). For severe cases, Jiangfu Tang (Ginger and Aconite Decoction) is used. If the patient gradually revives, the body warms up, and speech resumes slightly, inquire about other symptoms. If due to cold, the pulse is slow and tight; if complicated by qi stagnation with a surging pulse and stabbing pain, Fuzi Lizhong Tang (Aconite Pill to Regulate the Middle) with five fen of Muxiang (Vladimiria Root) is added; if complicated by wind with a floating pulse and dizziness, one qian of Fangfeng (Saposhnikovia Root) is added; if complicated by dampness with a soggy pulse, swelling, fullness, and pain, one qian of Baizhu (Atractylodes Macrocephala Rhizome) is added. For tendon and vessel tension, one qian of Mugua (Chaenomeles Fruit) is added. For joint pain, one qian of Gui (Cinnamon Twig) is added. Dantian Acupoint (CV-4) may also be moxibusted, with more sessions being preferable. Generally, cold invading the skin causes edema (as seen in frostbite swelling); cold invading the muscles causes heaviness, swelling, and fluid accumulation (due to impaired blood circulation), leading to splitting pain, which may occur in the limbs, chest and hypochondrium, shins and back, or lower abdomen radiating to the testicles (initially, the whole body suffers from cold, but later the pathogen concentrates in one area, entering where there is deficiency). It may transmit via meridians to the membrane source of the zang-fu organs, causing heart and abdominal pain, or invade the zang-fu directly, resulting in excruciating pain leading to unconsciousness. Cold invading sinews and bones causes spasms and bone pain with limited flexion and extension. Cold entering the fu and zang organs leads to death. Treatment must assess the severity. For severe cases, use Fuzi Lizhong Tang; add Mahuang (Ephedra Herb) and Xixin (Asarum Root) for no sweat; add Dingxiang (Clove) and Wuzhuyu (Evodia Fruit) for vomiting; add Sheng Chuanwu (Raw Radix Aconiti Lateralis Preparata) for yin toxicity; add Renshen (Ginseng Root) for a faint pulse nearly imperceptible. For mild cases, use Huanjin Zhengqi San (Golden Exchange Upright Qi Powder) with Fuzi, or Wuji San. For umbilical abdominal pain, white lips, cyanotic nails, and cold extremities, use Fuzi Lizhong Tang or Jiangfu Tang. If cold enters the Liver, add Mugua; if it enters the Lung, add Sangbaipi (Mulberry Root Bark); if it enters the Spleen, add Baizhu; if it enters the Heart, add Fuling (Poria). Grind each of Shexiang, Banxia (Pinellia Tuber), and Zaojiao (Gleditsia Sinensis Spine) two and a half qian into powder, fill the navel with it, cover with sliced fresh ginger, and moxibust until the hands and feet warm up, or moxibust Dantian Acupoint. Cases of cold extremities and abdominal colic caused by sexual intercourse are treated similarly. Do not let frozen individuals approach fire, as this forces cold into the heart and causes death. In northern regions, if frozen hands and feet are bathed in hot water or roasted by fire, the joints may detach. They must be rubbed slowly until warmth returns, or alternatively rubbed with snow to draw out the cold; recovery occurs when qi flows freely and warmth returns. This illustrates the principle: when frozen stiff like ice, sudden heat causes the melted part to separate from the unmelted part, leading to detachment. Furthermore, water seeks moisture, and fire seeks dryness. The cold on the skin is rejected by internal yang, which originally wishes to exit but lacks guidance. Rubbing with snow uses cold to attract cold, allowing it to adhere externally, thereby enabling internal yang to extend and restore warmth.